US Tech Solutions | Business Professional

1 day ago

newark, United States US Tech Solutions Full time

Duration: 4+ months contract with potential extends or Convert


Job Description:

This position is responsible for ensuring that Medicare Advantage membership enrollment is in sync by reconciling CMS enrollment records and Horizon enrollment records via review of Daily Transaction Reply Reports (DTRR) and the Monthly Membership Reports (MMR) while abiding by Federal Centers for Medicare and Medicaid Services guidance.


• Identification and communication of processing performance opportunities.

• Responsible for updating beneficiary requests for enrollment for premium withholding.

• Ensure that on a monthly basis all identified discrepancies resolutions are met with CMS timeframes.

• Prepare case documents for retroactive enrollment updates

• Performs other duties as assigned by management.


Core Individual Contributor Competencies:

• Personal and professional attributes that are critical to successful performance for Individual Contributors:

• Customer Focus

• Accountable

• Learn

• Communicate


Responsibilities:

• Reconciliation of all daily, weekly and monthly Medicare reports generated from CMS.

• Research and resolve enrollment discrepancies identified as a result of company and MMR report and Horizon records.

• Directly respond or support a response to inquiries that is rapid and professional to internal and external customers, not limited to Medicare Beneficiaries, Federal Regulators, Executives and Congress persons.

• Generating and ensuring compliance and accuracy of various types of member correspondence specific to retroactive enrollment submission to CMS.


Experience:

• Minimum of 5 years health insurance industry or related Medicare experience

• Excellent oral and written communication skills.

• Strong analytical and problem-solving skills.

• Proficiency in analysis techniques and Access database


Skills:

• Knowledge of system development life cycle and implementation methodologies preferred.

• Prefer ability to translate CMS regulatory guidance.

• Review of Daily Transaction Reply Reports (DTRR) and the Monthly Membership Reports (MMR)


Education:

• High School diploma or GED required, Bachelor's degree from an accredited college or university preferred.


About US Tech Solutions:

US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit www.ustechsolutions.com.


US Tech Solutions is an Equal Opportunity Employer.All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.


Recruiter Details:

Name: Raviteja

Email: raviteja.m@ustechsolutionsinc.com

Internal Id: 24-23705

  • Business Professional

    2 weeks ago

    newark, United States US Tech Solutions Full time

    Duration: 4+ months contract with potential extends or ConvertJob Description:This position is responsible for ensuring that Medicare Advantage membership enrollment is in sync by reconciling CMS enrollment records and Horizon enrollment records via review of Daily Transaction Reply Reports (DTRR) and the Monthly Membership Reports (MMR) while abiding by...

  • Business Professional

    2 weeks ago

    Newark, United States US Tech Solutions Full time

    Duration: 4+ months contract with potential extends or ConvertJob Description:This position is responsible for ensuring that Medicare Advantage membership enrollment is in sync by reconciling CMS enrollment records and Horizon enrollment records via review of Daily Transaction Reply Reports (DTRR) and the Monthly Membership Reports (MMR) while abiding by...

  • Senior Strategic Sourcing Consultant

    4 weeks ago

    Newark, United States US Tech Solutions Full time

    Responsibilities Develop and implement global procurement strategies aligned with organizational goals and objectives, focusing on supply chain efficiency and cost reduction. Collaborate with cross-functional teams, including R&D, manufacturing, and quality assurance, to identify procurement needs and ensure alignment with project timelines. Manage supplier...

  • Senior Strategic Sourcing Consultant

    4 weeks ago

    Newark, United States US Tech Solutions Full time

    Responsibilities Develop and implement global procurement strategies aligned with organizational goals and objectives, focusing on supply chain efficiency and cost reduction. Collaborate with cross-functional teams, including R&D, manufacturing, and quality assurance, to identify procurement needs and ensure alignment with project timelines. Manage supplier...

  • Senior Strategic Sourcing Consultant

    4 weeks ago

    Newark, United States US Tech Solutions Full time

    Duration: 14 months contract (with possible extension) Responsibilities · Develop and implement global procurement strategies aligned with organizational goals and objectives, focusing on supply chain efficiency and cost reduction. · Collaborate with cross-functional teams, including R&D, manufacturing, and quality assurance, to identify procurement needs...

  • Senior Strategic Sourcing Consultant

    4 weeks ago

    Newark, United States US Tech Solutions Full time

    Duration: 14 months contract (with possible extension)Responsibilities· Develop and implement global procurement strategies aligned with organizational goals and objectives, focusing on supply chain efficiency and cost reduction.· Collaborate with cross-functional teams, including R&D, manufacturing, and quality assurance, to identify procurement needs and...

  • Senior Strategic Sourcing Consultant

    4 weeks ago

    newark, United States US Tech Solutions Full time

    Duration: 14 months contract (with possible extension)Responsibilities· Develop and implement global procurement strategies aligned with organizational goals and objectives, focusing on supply chain efficiency and cost reduction.· Collaborate with cross-functional teams, including R&D, manufacturing, and quality assurance, to identify procurement needs and...

  • Field-Based RN with Assessment Expertise

    6 days ago

    Newark, New Jersey, United States US Tech Solutions Full time

    US Tech Solutions is seeking a skilled Field-Based Registered Nurse (RN) to join our team. This role involves conducting assessments for PCA and MDC services, utilizing established guidelines and assessments to ensure the appropriate level of care and services are authorized.The ideal candidate will possess experience in field-based nursing, with a strong...

  • Field RN

    2 weeks ago

    Newark, United States US Tech Solutions Full time

    Job DescriptionDuration: 5+ months contract with potential extends or ConvertJob Description:This field-based position is responsible for performing assessments for PCA and MDC services using established guidelines and assessments to ensure appropriate level of care and services are authorized.Role Notes from Pontoon/Manager:- Temp to Perm potential-...

  • Field RN

    2 weeks ago

    Newark, United States US Tech Solutions Full time

    Job DescriptionDuration: 5+ months contract with potential extends or ConvertJob Description:This field-based position is responsible for performing assessments for PCA and MDC services using established guidelines and assessments to ensure appropriate level of care and services are authorized.Role Notes from Pontoon/Manager:- Temp to Perm potential-...

  • Informatica Cloud Marketplace Solution Designer

    4 weeks ago

    Newark, New Jersey, United States JSR Tech Consulting Full time

    Job Title: Informatica Cloud Marketplace DeveloperAbout the RoleWe are seeking a highly skilled Informatica Cloud Marketplace Developer to join our team at JSR Tech Consulting. As a key member of our data integration team, you will be responsible for designing, developing, and maintaining Informatica Cloud Data Marketplace solutions.Responsibilities* Design...

  • Solutions Architect

    1 month ago

    newark, United States JSR Tech Consulting Full time

    Long term, right to hire position for a major Financial client.Hybrid work environment, 2 - 3 days per week in Newark, NJ.Solution Architect - Job DescriptionThe Global Technology organization is seeking a Senior level Solution Architect to engage in and lead some very exciting work. Reporting to the Lead Solution Architect, this role will engage in the...

  • Solutions Architect

    2 months ago

    Newark, United States JSR Tech Consulting Full time

    Long term, right to hire position for a major Financial client.Hybrid work environment, 2 - 3 days per week in Newark, NJ. Solution Architect - Job DescriptionThe Global Technology organization is seeking a Senior level Solution Architect to engage in and lead some very exciting work. Reporting to the Lead Solution Architect, this role will engage in the...

  • Business Development Manager

    2 weeks ago

    Newark, United States Toshiba America Business Solutions Full time

    Business Development Manager Thermal - ChannelsFirst year potential total compensation is $125,000.00.Base Salary: $78,000.00 to $90,000.00 depending on experience.First-year on-track earnings at 100%, including base, and commission of $125,000.00 (approximate).Toshiba America Business Solutions, Inc. is a global industry leader in digital displays, document...

  • Solutions Architect

    3 weeks ago

    Newark, NJ, United States JSR Tech Consulting Full time

    Long term, right to hire position for a major Financial client.Hybrid work environment, 2 - 3 days per week in Newark, NJ. Solution Architect - Job DescriptionThe Global Technology organization is seeking a Senior level Solution Architect to engage in and lead some very exciting work. Reporting to the Lead Solution Architect, this role will engage in the...

  • Business Development Manager

    2 weeks ago

    Newark, United States Toshiba America Business Solutions Full time

    First year potential total compensation is $125,000.00. Base Salary: $78,000.00 to $90,000.00 depending on experience. First-year on-track earnings at 100%, including base, and commission of $125,000.00 (approximate). Toshiba America Business Solutions, Inc. is a global industry leader in digital displays, document security and software solutions. We...

  • Business Development Manager

    1 week ago

    Newark, United States Toshiba America Business Solutions Full time

    Description First year potential total compensation is $125,000.00. Base Salary: $78,000.00 to $90,000.00 depending on experience. First-year on-track earnings at 100%, including base, and commission of $125,000.00 (approximate). Toshiba America Business Solutions, Inc. is a global industry leader in digital displays, document security and software...

  • Business Development Manager

    2 weeks ago

    Newark, United States Toshiba America Business Solutions Full time

    First year potential total compensation is $200,000.00.Base: $91,000.00 to $100,000.00 depending on experience.First-year on-track earnings at 100%, including base, commission, bonus, and expense allowance of $200,000.00 (approximate)Toshiba America Business Solutions, Inc. is a global industry leader in digital displays, document security and software...

  • Business Development Manager

    4 weeks ago

    Newark, United States Toshiba America Business Solutions Full time

    Description Business Development Manager - Enterprise Thermal (Northeast Territory) First year potential total compensation is $200,000.00. Base: $91,000.00 to $100,000.00 depending on experience. First-year on-track earnings at 100%, including base, commission, bonus, and expense allowance of $200,000.00 (approximate) Toshiba America Business Solutions,...

  • Business Development Manager

    3 weeks ago

    Newark, United States Toshiba America Business Solutions Full time

    Description First year potential total compensation is $200,000.00. Base: $91,000.00 to $100,000.00 depending on experience. First-year on-track earnings at 100%, including base, commission, bonus, and expense allowance of $200,000.00 (approximate) Toshiba America Business Solutions, Inc. is a global industry leader in digital displays, document security...